This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (3) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Glascoe, F. P. Articles by Robertshaw, N. S. Search for Related Content PubMed PubMed Citation Articles by Glascoe, F. P. Articles by Robertshaw, N. S. Social Bookmarking                         What's this?

Can a Broadband Developmental-Behavioral Screening Test Identify Children Likely to Have Autism Spectrum Disorder?

Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, Frances.P.Glascoe{at}Vanderbilt.edu

Michelle M. Macias, MD

Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina

Lynn M. Wegner, MD

Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Nicholas S. Robertshaw

Forepath.org, Washington, DC

Because services for children with autism spectrum disorder (ASD) are scarce, when children fail a broadband screening measure, providers need to carefully discern which children need ASD evaluations and which do not. This research considers how well a broadband screening test sorts those with and without probable ASD. The subjects were 427 children between 18 and 59 months of age with elevated risk scores on broadband screening, ie, Parents' Evaluation of Developmental Status (PEDS), a 10-item measure eliciting parents' concerns. Parents also completed the Modified Checklist of Autism in Toddlers (M-CHAT), an autism specific screen. The results showed that of the 427 children at risk on PEDS, 34% (N = 144) passed the M-CHAT. To determine whether these potential overreferrals could be reduced, parents' concerns on PEDS were used to predict M-CHAT results. Three or more discrete types of concerns, varying by age, characterized children who failed the M-CHAT while fewer than 3 were associated with passing. This reduced overreferrals by 70% while maintaining high levels of sensitivity (81%). Although compliance with the American Academy of Pediatrics recommendations for both broadband and autism-specific screening at 18 and 24 months is still recommended, viewing performance patterns on a broadband screening test can substantially reduce overreferrals to autism specialty services.

Key Words: parents' concerns • autism • child development • developmental screening

References

• Filipek PA, Accardo PJ, Ashwal S., et al. Practice parameter: Screening and diagnosis of autism. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society. Neurology. 2000;55:468-479.
• American Academy of Pediatrics. Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics. 2006;118:405-420.[Abstract/Free Full Text]
• Silverstein M., Sand N., Glascoe FP, Gupta B., Tonniges T., O'Conner K. Pediatricians' reported practices regarding developmental screening: Do guidelines work? And do they help? Pediatrics. 2005;116:174-179.[Abstract/Free Full Text]
• Halfon N., Regalado M., Sareen H., et al. Assessing development in the pediatric office. Pediatrics. 2004;13:1926-1933.
• Yeargin-Allsopp M., Rice C., Karapurkar T., Doernberg N., Boyle C., Murphy C. Prevalence of autism in a US metropolitan area. JAMA. 2003;289:49-55.[Abstract/Free Full Text]
• Newacheck PW, Halfon N. Prevalence and impact of disabling chronic conditions in childhood. Am J Public Health. 1998;88:610-617.[Abstract/Free Full Text]
• Glascoe FP Parents' Evaluations of Developmental Status: A Method for Detecting and Addressing Developmental and Behavioral Problems in Children. Nashville, TN: Ellsworth & Vandermeer Press; 2006.
• Glascoe FP Collaborating with Parents: Using Parents' Evaluations of Developmental Status to Detect and Address Developmental and Behavioral Problems. Nashville, TN: Ellsworth & Vandermeer Press; 1998.
• Glascoe FP Evidence-based approach to developmental and behavioural surveillance using parents' concerns. Child Care Health Dev. 2000;26:137-149.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Robins DL, Fein D., Barton ML, Green JA The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Disord. 2001;31:131-144.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Dumont-Mathieu T., Fein D. Screening for autism in young children: The Modified Checklist for Autism in Toddlers (M-CHAT) and other measures. Ment Retard Dev Disabil Res Rev. 2005;11:253-262.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Flores G., Olson L., Tomany-Korman SC Racial and ethnic disparities in early childhood health and health care. Pediatrics. 2005;115:183-193.[CrossRef]
• Selden TM Compliance with well-child visit recommendations: Evidence from the medical expenditure panel survey, 2000-2002. Pediatrics. 2006;118:1766-1778.[CrossRef]
• Young L., Pinto-Martin J., Warszawa A., Giarelli E., Levy S. Comparison of a general developmental screening tool and an autism specific screening tool in autistic spectrum disorder (ASD) assessment. Abstract presented at the Annual Meeting of the Society for Developmental Pediatrics. J Dev Behav Pediatr. 2006;27:43.

This version was published on December 1, 2007

Clinical Pediatrics, Vol. 46, No. 9, 801-805 (2007)
DOI: 10.1177/0009922807303928


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (3) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Glascoe, F. P. Articles by Robertshaw, N. S. Search for Related Content PubMed PubMed Citation Articles by Glascoe, F. P. Articles by Robertshaw, N. S. Social Bookmarking                         What's this?